Implications of Marijuana Decriminalization on the Practice of Pulmonary, Critical Care, and Sleep Medicine. A Report of the American Thoracic Society Marijuana Workgroup

Douglas, Ivor S.; Albertson, Timothy E; Folan, Patricia; Hanania, Nicola A.; Tashkin, Donald P.; Upson, Dona; Leone, Frank T.

doi:10.1513/annalsats.201504-195ar

Cited by 22 publications

(20 citation statements)

References 84 publications

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“…Furthermore, studies reported disturbed sleep may last up to 45 days post cessation, making it the longest lasting of the withdrawal symptoms . A growing body of evidence has implicated sleep difficulty as a significant factor in predicting cessation outcome and relapse . Therefore, we postulate pharmacological approaches targeting this key symptom may improve cessation outcome, ease of withdrawal and thereby, retention in treatment.…”

Section: Discussionmentioning

confidence: 98%

“…Cannabis is the most commonly used illicit substance globally and on the path of legislation in several countries and various states in the U.S. Several studies have looked at pharmacological treatment of Cannabis Use Disorder (CUD) inclusive of withdrawal symptoms. DSM‐5 has now added cannabis withdrawal to its diagnostic compendium with its reliability and validity being demonstrated in preclinical, clinical, and epidemiological studies .…”

Section: Introductionmentioning

confidence: 99%

“…Sleep disturbance has been reported as one of the most severe and common cannabis withdrawal symptoms, which may persist beyond the acute withdrawal phase . There is a breadth of evidence to support that sleep difficulties following cannabis cessation play a crucial role in predicting treatment outcome and is a risk factor for relapse . In the clinical management of insomnia disorder, pharmacological treatment is most appropriate for patients with acute insomnia (less than 3 months) …”

Section: Introductionmentioning

confidence: 99%

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What do we know about the pharmacotheraputic management of insomnia in cannabis withdrawal: A systematic review

Zhand

Milin

2018

American J Addict

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Background and Objectives Sleep disturbance is one of the hallmarks of cannabis withdrawal. Studies have indicated that treatment of this key symptom may facilitate abstinence. In the present paper we aim to provide a systematic review of the extant literature on pharmacological management of sleep disturbance associated with cannabis withdrawal. Method We conducted a systematic literature search across five electronic databases including PubMed, Psycinfo, MEDLINE, Cochrane review and Embase. Human studies using a pharmacological treatment for sleep disturbances associated with cannabis withdrawal were included. Review articles, case‐series, open trials, posters, and editorials were excluded. Results Seventeen publications, involving 562 participants, were included in this review. Major limitations involved small sample size, high dropout rate, methodological limitations, and heterogeneity of participants. Most of the studies were at high risk of bias, further downgrading the level of evidence. A meta‐analysis was not performed due to lack of quantitative data, marked heterogeneity and low quality of the included studies. Conclusion There is not sufficient evidence for any of the reviewed treatment options. Methodological limitations in a majority of the studies rendered their findings preliminary. Of the twelve investigated pharmacological agents, Gabapentin, Lofexidine, Mirtazapine, Quetiapine, and Zolpidem showed some primary benefits for treatment of sleep difficulties associated with cannabis withdrawal; however, future prospective studies are required to confirm such results. Scientific Significance This review examines the current evidence for potential pharmacological options for treatment of cannabis withdrawal and associated sleep disturbance. It furthers our knowledge and provides groundwork for future research. (Am J Addict 2018;27:453–464)

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What do we know about the pharmacotheraputic management of insomnia in cannabis withdrawal: A systematic review

Zhand

Milin

2018

American J Addict

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“…Cannabis Use, Lung Cancer, and Related Issues symptoms of chronic bronchitis (cough, wheeze, and sputum), with no additive effects observed in combined marijuana and tobacco smoking. 22 A large cross-sectional study of adults did not demonstrate any adverse spirometric changes with cumulative lifetime marijuana use of up to 20 joint-years; however, greater than 20 joint-years was associated with a twofold increase in the odds of a ratio of forced expiratory volume in 1 second to forced vital capacity less than 70%. This was a result of increase in forced vital capacity rather than a decline in forced expiratory volume in 1 second, as is typical with obstructive airway disease.…”

Section: April 2018mentioning

confidence: 95%

Cannabis Use, Lung Cancer, and Related Issues

Jett

Stone

Warren

et al. 2018

Journal of Thoracic Oncology

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The cannabis plant and its derivatives have been exploited for centuries for recreational and medicinal purposes, with millions of regular users around the world. The recreational use of cannabis is reflective of its neuropsychiatric effects, such as anxiolysis and euphoria. However, cannabis appears to have an emerging therapeutic role, especially in chronic disease and as an adjunct to cancer treatment. Increasing evidence supports cannabis in the management of chemotherapy-induced nausea and vomiting (CINV) and for pain management; however, studies are limited, particularly by difficulties associated with standardized dosing estimates and inability to accurately assess biologic activities of compounds in cannabis and derivative products. Smoking cannabis has not been proved to be a risk factor in the development of lung cancer, but the data are limited by small studies, misclassification due to self-reporting of use, small numbers of heavy cannabis smokers, and confounding of the risk associated with known causative agents for lung cancer (such as parallel chronic tobacco use). Cannabis and its biologically effective derivatives warrant additional research, ideally, controlled trials in which the cannabidiol and the delta-9-tetrahydrocabinol strength and use are controlled and documented.

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“…17,18 There is also no conclusive evidence that cannabis use increases the risk for lung cancer, although cannabis users often smoke cigarettes, making it difficult to isolate the impact of regular cannabis use on the risks for chronic lung disease. [19][20][21] The best evaluation of the association between smoking cannabis and lung cancer risk, after adjustment for tobacco use, is a pooled analysis of six case-control studies with 2159 patients with lung cancer and 2985 controls that failed to find evidence of an increased risk for lung cancer among longterm cannabis smokers. 20 Given the changing potency and patterns of use of cannabis, including use by non-cigarette smokers, there is an urgent need to conduct research to assess its effects on lung health.…”

Section: Prevention and Early Detectionmentioning

confidence: 99%

Scientific Advances in Thoracic Oncology 2016

Soo

Cummings

Jett

et al. 2017

Journal of Thoracic Oncology

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Lung cancer care is rapidly changing with advances in genomic testing, the development of next-generation targeted kinase inhibitors, and the continued broad study of immunotherapy in new settings and potential combinations. The International Association for the Study of Lung Cancer and the Journal of Thoracic Oncology publish this annual update to help readers keep pace with these important developments. Experts in thoracic cancer and care provide focused updates across multiple areas, including prevention and early detection, molecular diagnostics, pathology and staging, surgery, adjuvant therapy, radiotherapy, molecular targeted therapy, and immunotherapy for NSCLC, SCLC, and mesothelioma. Quality and value of care and perspectives on the future of lung cancer research and treatment have also been included in this concise review.

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Implications of Marijuana Decriminalization on the Practice of Pulmonary, Critical Care, and Sleep Medicine. A Report of the American Thoracic Society Marijuana Workgroup

Cited by 22 publications

References 84 publications

What do we know about the pharmacotheraputic management of insomnia in cannabis withdrawal: A systematic review

What do we know about the pharmacotheraputic management of insomnia in cannabis withdrawal: A systematic review

Cannabis Use, Lung Cancer, and Related Issues

Scientific Advances in Thoracic Oncology 2016

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